Mercy Managed Care
First Choice of the Midwest
Address:
First Choice of the Midwest, Inc.
100 S. Spring Ave., Suite 220
Sioux Falls, SD 57104
Phone: (605) 332-5955
Fax: (605) 332-5953
Toll Free: (888) 246-9949
Website: www.1choicem.com
E-mail: info@1choicem.com
PPO PRODUCTS & SERVICES
Claims Repricing:
First Choice of the Midwest provides local in-house repricing with a 1-5 day turn around time.
Benefits:
Benefits have been enhanced to encourage usage of PPO providers. Please refer to the plan benefit booklet to find any information on PPO/Non-PPO Benefit differentials, covered benefits, etc. Remember that First Choice of the Midwest is not an insurance company and does not pay claims. You need to call the insurance plan administrator for benefit questions.
It is the responsibility of the patient/member to make certain that the providers they see are in the First Choice of the Midwest's PPO network. They should ask questions when they are being referred elsewhere to ensure that their physician is trying to stay within the network.* The PPO network is subject to change, so for the most updated information on participating porviders, call First Choice of the Midwest at (605) 332-5955 or (888) 246-9949. Remember, the patient/member always have "freedom of choice". They can be elibible for benefits at both PPO and Non-PPO providers; however, their benefit will be greater at a PPO provider. First Choice of the Midwest has established pre-negotiated rates at PPO Providers versus seeing a Non-PPO Provider where they run the risk of having additional out-of-pocket expenses.
*Some services such as laboratory, anesthesiology, pathology, radiology, etc., received at a PPO hospital may be subcontracted by the hospital and may not be participating in the PPO.
National Preferred Provider Network (NPPN) is an affiliate network of First Choice of the Midwest. Our negotiated rates would apply. The EOB may or may not reference First Choice of the Midwest. It may say “Network: NPPN/FCM.”
Contact: Kristina Pyle (kpyle@1choicem.com)
Phone: 605.332.5955 Ext 308 Fax: 605.332.5953
Credentialing is delegated to Mercy Medical Center – North Iowa.
Please contact Kristi Larsen at 641.422.6986 with any questions/comments regarding this web page.